Abstract
BackgroundFixation of radial neck fractures can be achieved with a plate and screw construct or with two screws. This study evaluated the biomechanical properties of three different fixation methods following radial neck fractures.MethodsTwenty-four fourth-generation composite radii were sawed to simulate an unstable radial neck fracture. They were then instrumented with a plate and screw construct or two different orientations (crossed and parallel) of screw fixation. Implants were tested under bending and torsional loads via a tension torsion composite test system. Bending and torsional failure loads were added to the remaining implant-radius constructs if they did not fail during the previous tests.ResultsDuring the bending loading test, the crossed-screw group showed the greatest stiffness, followed by the parallel-screw group, the plate group demonstrating the weakest stiffness. There was no significant difference between the crossed- and the parallel-screw groups. However, there was a significant difference between the two screw groups and the plate group. During the bending failure test, the largest stiffness was found for the crossed-screw group, while the plate group exhibited the smallest stiffness. There was a significant difference between the three groups. During the torsion loading test, the highest stiffness was observed for the crossed-screw group, while the plate group showed the lowest stiffness. In the torsion failure test, the failure torques were 11.97 ± 2.659, 8.531 ± 1.768, and 7.079 ± 1.666 N m respectively for the crossed-screw, parallel-screw, and plate groups. There was a significant difference between the crossed-screw group and the two other groups.ConclusionsCrossed screws and plate fixation are commonly used in clinical practice to treat simple radial neck fractures. While the present study shows that the parallel-screw method results in similar biomechanical strength as the two other techniques, it has the advantages of reaching limited wound exposure and having the implant buried. Therefore, it may be widely used in clinical practice.
Highlights
Fixation of radial neck fractures can be achieved with a plate and screw construct or with two screws
We aimed at comparing the stiffness and strength of the plate and two different screw orientations, the plate and the crossed screw being commonly used in clinical practice, and the parallel screw being designed by us for this study
The stiffness of the crossed-screw group was the largest compared with the two other structures
Summary
Fixation of radial neck fractures can be achieved with a plate and screw construct or with two screws. This study evaluated the biomechanical properties of three different fixation methods following radial neck fractures. Radial head and neck fractures are uncommon, their reported incidence being approximately 55.4 per 100,000 persons [1]. The purpose of this study was to determine the biomechanical properties of the bending and torsional stiffnesses of a plate and two different screw fixation orientations (crossed and parallel) in an unstable radial neck fracture. A simple radial neck fracture model was used to standardize our investigation. This model does not reproduce radial head and neck fractures, the results of this study can still help orthopedic surgeons to develop the most reasonable internal fixation pattern. We aimed at comparing the stiffness and strength of the plate and two different screw orientations, the plate and the crossed screw being commonly used in clinical practice, and the parallel screw being designed by us for this study
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